Functional diffusion map as an imaging predictor of functional outcome in patients with primary intracerebral...

Predicting outcome in patients with primary intracerebral haemorrhage (ICH) in the acute stage can provide information to determine the best therapeutic and rehabilitation strategies. We prospectively investigated the predictive value of the functional diffusion map (fDM) in the acute stage of ICH.

47 patients with ICH were enrolled for clinical evaluation and MRI within 24 h of symptom onset and 5 days after ICH. Functional diffusion mapping prospectively monitored the apparent diffusion coefficient (ADC) maps of perihaematomal oedema. Consequently, the change in perihaematomal oedema was classified into three categories: increased, decreased, or no significant change. Clinical outcomes were evaluated 6 months after ICH according to the modified Rankin Scale. Correlation between clinical outcome and the fDMs was performed.

Among the clinical variables, thalamic haematoma, serum glucose level and National Institutes of Health Stroke Scale scores were significantly different between the good- and poor-outcome groups. The percentage of oedematous tissue undergoing significant change between baseline and Day 5 was also significantly different between the groups.

fDMs allow for spatial voxel-by-voxel tracking of changes in ADC values. It may be feasible to use fDMs to predict the functional outcome of patients with ICH during the acute stage. Advances in knowledge The use of fDMs for stroke study is demonstrated. fDMs may be more suitable to reflect the pathophysiological heterogeneity within oedemas and may facilitate another thinking process for imaging study of stroke and other neurological diseases.